CPR - pro or con

[Doc_Glock]

Here’s a harrowing story about a snake bite and 3 hrs of CPR. I knew everyone involved.

https://www.outsideonline.com/outdoo...-survival/bit/

Not to mention the 26 hours of mouth to mouth. Excruciating.

[Default.mp3]

That's interesting given that CPR for Professional Rescuers (or whatever they're titling it these days) still requires 30:2 for adults and 15:2 for peds. That's opening your guys/department up to a ton of liability, since you're not following the published standard of care for professional rescuers. You're quite literally in breach of an established duty, and committing negligence.

Was this approved by your medical director? At least then it'd fall on their shoulders/license.

For my VFD, it was a department-wide policy change, so I would almost certainly think that it was something changed by medical direction. We weren't a particularly progressive department when it came to medical, so that was a noticeable shift.

I'm not too sure about the current SAR team (which operates under the SO's jurisdiction), as I didn't attend any of their medical pipeline since I already had my EMT, but the current preferred approach is compression only, due to the difficulty in getting good compressions to begin with in the backcountry, since the terrain is rarely even and thus your patient can be in wonky positions. Then again, we didn't put too much emphasis on this, given that it was extremely unlikely for us to do single-rescuer responses (as this is very much against SOP except under extraordinary circumstances). We still very much do the standard 30:2 when there are multiple rescuers and no advanced airway, though CPR in general is extremely rare, given our response times and the typical patients we have.

[UNM1136]

Running EMS in the early 90s, my home state would give you a license if you had National Registry. At the time 26 states just issued a license if you were National Registry. 35 states would grant reciprocity for my state's license.

According to my ALS instructors at the time there were only two medical schools in the country that required ACLS certification for graduates. At the time a paramagician, depending on protocols, was as valuable as many a MD in arrest cases, because most Docs were not trained to the standard. One of my Instructors left EMS to become a cardiologist.

I always thought the idea of hands only CPR was dumbing down for the masses. We used to hold American Heart Association (required at the time for state and NR licensure) CPR in college auditoriums. Then American Red Cross CPR, but I never did it, because AHA was the EMS standard, I couldn't tell you the difference between the two.. The two orgs were at odds, to put it mildly. Our EMT licenses required AHA. Period. Or you did not get a license.

Now we train hands only in football stadiums in 1-2 hour blocks for thousands of people over a weekend.

We were taught that defib was not viable without pharmacology. 4-5 years later we had EMT-D(fib). Now we put auto d-fibs in gyms and police cars, and make folks watch youtube videos to become "certified".

And we were ALWAYs taught that oxygen to the heart and brain were paramount. Compressions moved the blood, but vitamin O(xygen) was the life saver, and we had to in the worst case provide it by our own breath, and in the best case we used a demand valve (really, really dating myself) or a BVM at 15L O2 to force O2 in.

I guess it is better than nothing, Kinda like being mugged when you only have a .25 auto on your person. Better than nothing, but not "good".

pat

[TGS]

Running EMS in the early 90s, my home state would give you a license if you had National Registry. At the time 26 states just issued a license if you were National Registry. 35 states would grant reciprocity for my state's license.

According to my ALS instructors at the time there were only two medical schools in the country that required ACLS certification for graduates. At the time a paramagician, depending on protocols, was as valuable as many a MD in arrest cases, because most Docs were not trained to the standard. One of my Instructors left EMS to become a cardiologist.

I always thought the idea of hands only CPR was dumbing down for the masses. We used to hold American Heart Association (required at the time for state and NR licensure) CPR in college auditoriums. Then American Red Cross CPR, but I never did it, because AHA was the EMS standard, I couldn't tell you the difference between the two.. The two orgs were at odds, to put it mildly. Our EMT licenses required AHA. Period. Or you did not get a license.

Now we train hands only in football stadiums in 1-2 hour blocks for thousands of people over a weekend.

We were taught that defib was not viable without pharmacology. 4-5 years later we had EMT-D(fib). Now we put auto d-fibs in gyms and police cars, and make folks watch youtube videos to become "certified".

And we were ALWAYs taught that oxygen to the heart and brain were paramount. Compressions moved the blood, but vitamin O(xygen) was the life saver, and we had to in the worst case provide it by our own breath, and in the best case we used a demand valve (really, really dating myself) or a BVM at 15L O2 to force O2 in.

I guess it is better than nothing, Kinda like being mugged when you only have a .25 auto on your person. Better than nothing, but not "good".

pat

You've definitely dated yourself 🤣

Does differential tourniquet application and MAST trousers also ring a bell? The former was out by the time I started, but the latter was still taught.

[ccmdfd]

You've definitely dated yourself 🤣

Does differential tourniquet application and MAST trousers also ring a bell? The former was out by the time I started, but the latter was still taught.

Does for me!

[DpdG]

Like many who already posted, my track record for CPR as a small town cop is not good. I don’t know how many losses I’ve had (at least 20), but I know I’ve had exactly 1.5 saves as part of a team of first responders. Both were on older-to-very elderly males. The full blown save was a 70-ish uncle at a wedding who originally got called in as a seizure in the vestibule. He was seizing but had a decent pulse when I got there, but went into CA as the FD/EMS people arrived. Manual compressions pit-stop style until the Lucas got hooked up, with full AED/Monitor and I/O meds. He made a full meaningful recovery after surgical cardiac care. The 1/2 was a 85+ YOM who we got back for a few hours so his family could arrive and say their goodbyes.

With the benefit of hindsight, I really wish CPR instruction included the bit about the sternum breaking and resulting sensation when giving effective compressions. That was likely the most shocking part about the first time administering CPR.

[Robert Mitchum]

Call it a win for the facility ...not as much paperwork but a loss for the inmate who died at the ER.
I tried as hard as I could to save him in the unit I was working.
Everyone always joked saying they would not help a dying inmate ... my human in stinks kicked in with no hesitation to save him.
Thinking about it now ........ melancholy.

[ST911]

You've definitely dated yourself 🤣

Does for me!

It's like dinosaurs walking the earth. We should get tee shirts made. Who's still got leeches in their jump-bag?

[TGS]

It's like dinosaurs walking the earth. We should get tee shirts made. Who's still got leeches in their jump-bag?

No leeches, but I do still have some TK-4 "Tourni-quicks".

[RoyGBiv]

Call it a win for the facility ...not as much paperwork but a loss for the inmate who died at the ER.
I tried as hard as I could to save him in the unit I was working.
Everyone always joked saying they would not help a dying inmate ... my human in stinks kicked in with no hesitation to save him.
Thinking about it now ........ melancholy.

Sometimes it's about how you feel, not about the other guy. Not your job to mete justice. Good on you.